No easy answers to this one. We all have our dreams of women united for the
good of all. It is a vexed question, but we must value and respect each
other's opinion. I also sometimes think, "where are the women behind us?"
For years W.A has had a very strong Birthplace Support group. Many women
have lobbied for the rights of women to birth where and with whom they chose
and to have medical and hospital backup for themselves and their midwives.
At this moment, the dedicated few (consumers) have burnt out and even though
there are lots of women who support midwives and birthplace rights, there is
a struggle to find enough women to take over the positions in Birthplace. I
don't know the answer, but we must keep trying. Regards, Mary Murphy
----- Original Message -----
From: Trish David <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Monday, August 23, 1999 5:32 PM
Subject: Re: Fw: Consumers and ACMI attention Irene.
> Dear Deirdre,
> Please don't denigrate someone's opinion as a joke. It was a considered
> response. I need to ask some critical questions.
>
> >I hope Irene that your letter is a joke because if what you are saying is
> >what you feel then surely you are taking as ostrich approach to consumer
> >involvement in Maternity Services. You will never get it right until you
> >not only have consumer imput but have equal imput at all levels of your
> >training and through out your service.
>
> 1. how is 'equal' input possible given all the power differentials
inherent
> in the midwife/woman relationship? When we identify these differentials
> what do we do with them? How do we work with them?
>
> At present midwives are accountable
> >only to Midwives and maybe the medical profession at large but as
maternity
> >services exist now midwives are not accountable to the one group they
> >should be Mothers (Consumers)
>
>
> 2. all midwives are accountable on many levels and to many quarters for
> their own actions. Ask any tribunal veteran. They are most certainly
> accountable to the woman both singly through a duty of care and in the
> context of their social contract, and collectively through registering
> practices, and their competencies, etc. Where do you get the impression
> they are not?
>
> >If anything you need to take a much closer look at exactly how NZ got
their
> >autonomy and you will realize that many many consumer groups came
together
> >in support. The Government is not going to listen to a bunch of Midwives
> >when the have Ob's in their ears. The Government will only change it's
> >mind when it's sees enough people pushing as to affect the VOTE!
>
> 3. has anyone advocating the NZ approach really looked at it critically?
> Do all midwives in NZ practice in partnership and in a professionally
> autonomous way? What are the barriers and facilitators to this, and what
> are the continuing problems they experience? How well does the model
apply
> to the Australian context?
>
>
> 4. do you all realise what you already have that is very wonderful indeed
> in this country? Look around and count at least a few blessings. Other
> countries look to us, but that doesn't mean we can't strive for more. It
> does mean we should idnetify our strengths to counter our anguish.
>
> >Don't be fooled thinking that you can gain or maintain any sort of
autonomy
> >in this society with out the full support of your "BIRTHING SISTERS" you
> >have no hope.
>
> 5. as to birthing sisters....I hesitate to collectivise ourselves in such
a
> way. Helen and Irene raise some interesting questions, and I raised the
> cautions earlier (as has Carol Thorogood in other contexts) of running
away
> with seductive ideas without subjecting them to serious critique. There
> are differing agendas for women and midwives, just as there are common
> ones, and Marina articulated this well in her post last week, that perhaps
> women don't want to have a say in everything we do, just in that which
most
> affects them. In this we need to ally with them. We then need their
> say...help me to help you...could be the motto, on issues where our
threats
> threaten what they want from us. Examples include erosion of midwifery
> models of care and expansion of alternatives in place of birth. Do the
> women really care whether we educate ourselves in one way or another? Or
> whether we work internationally? How we are constituted as a professional
> body? What alliances we form for our own strategic positioning as long as
> these don't affect their concerns?
> I Will be the first to
>
> >admit that constantly being under the watchful eye of a group of
consumers
> >even hand picked ones can be sometimes quite harrowing especially if they
> >understand they have the right to openly evaluate the care you give, the
> >service you provide but if a midwife can't stand up to this kind of
> >evaluation then I can only wonder what it is she has to hide.
>
> As to partnerships. If partnerships between midwives and women are to be
> equal in such a way as having the midwife always under the watchful eye of
> the 'consumer', especially in the atmosphere of intense scrutiny as your
> language suggests, where is the trust? Where is the return accountability
> of the consumer to the midwife?
>
> Finally, to Robin. Midwives do resist bad practices everyday, and many
> burnout, many despair and some even suicide or succumb to mental
breakdowns
> becuase of the incessant battle to protect the women's experience or to
> fight injustice. They too are (mostly) women in a patriarchal world, and
> so are perhaps not the best ones to always be the advocate. Women need
> (all of them, not just a few) to educate themselves to make the choices
> they need to. In every context. Midwives can help, but they can't do it
> for you. Together - indomitable.
>
> And last -- without trying to teach my granny to suck eggs - Kathleen,
what
> about a reconception of what it means to be a profession along feminist
> lines, taking what is best from the old models of a profession, and
> applying the critique and wisdom of some of the feminist (almost don't
dare
> say it) nursing literature. Midwifery discourse is full of it already,
but
> doesn't talk it as well as nursing does. Reconstructed profession of
> midwifery would work on power with, close nexus between midwife, woman and
> community for justice in birthing, excellence in education and research,
> principles of power sharing and mutual empowerment, recognition of each
> other as expert knowers, etc. The bones are already there in the
> definition of a midwife, in midiwfery curricula, in what women are asking
> of us and prepared to give in return. And it's clearly articulated in
> Guilliland & Pairman as well.
> Enough! (I've jsut finished an inspiring tutorial with my third year
> nursing students on what might professional mean. From the mouths of
babes
> really!).
>
> Cheers, now. Trish
>
> end note
>
> . I wonder how many midwives out there not
> >only provide but encourage honest evaluation of the service they have
> >provided. How many midwives would actually change they way they practice
> >based on the written feed back of consumers. How many of you who
practice
> >in either private practice or caseload situations have consumers that you
> >are directly accountable to on regular occassions .
>
> I do and have, and also know of many other instances and ways in which
this
> occurs. Quality improvement (global initiatives of a service) right
> through to intensely personal and individual methods of both peer and
woman
> evaluation. Do we now subject the consumer movement to the same test of
> altruism in relation to performance? If you really want equality, this is
> what you will get. How has the consumer helped midwifery so far? Fair
> question. And I'm not being deliberatel provocative, becuase of course
> they have.
>
>
> Really the end now. Off to take some days off to prepare for the
conference.
>
>
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